Abstract
Immune Checkpoint Inhibitor Use and Hospitalizations Near the End of Life (FR221)
Journal of pain and symptom management, Vol.63(5), pp.808-809
05/2022
DOI: 10.1016/j.jpainsymman.2022.02.253
Abstract
Outcomes
1. Define the function of immune checkpoint inhibitors (ICIs) and list at least 3 common agents used for oncologic therapy
2. After the lecture the learner will be able to describe the outcomes associated with ICI use near the end of life, including the likelihood of outpatient follow-up and receiving further oncologic treatment
Treatment with immune checkpoint inhibitors (ICIs) is rapidly becoming more common among the oncologic population as studies show improving survival benefits and newer agents with tolerable side effect profiles become available. Unfortunately, ICI use near the end of life is common. We evaluated hospital admissions occurring near the end of life for patients on ICI treatment.
To describe ICI use and hospitalization outcomes near the end of life.
We studied 441 patients who were treated with ICIs at the University of Iowa and died between August 2014 and December 2018. We analyzed hospital admissions within 90 days before death. Length of stay, palliative care consultation, discharge location, postdischarge oncology follow-up, and additional cancer-directed therapy were assessed. Univariate and multivariate analysis was done to identify the relationship between the above variables.
Among 441 patients, 386 (87.5%) patients had a total of 560 hospitalizations in the last 90 days of life. Of 37 discharges to rehabilitation or skilled nursing facilities (SNFs), only 15 (40.5%) had completed an outpatient oncology follow-up (p < .001) before readmission or death versus 231/316 (73.1%) discharges to home. Only 13.5% discharges to rehab or SNF received further cancer-directed therapy from their oncologists (p < .001), compared to 45.6% of home discharges. Of the 152 (27.1%) discharges to hospice or hospital deaths, palliative care was more frequently involved (p < .001).
In patients on ICI treatments hospitalized near the end of life, discharges to rehabilitation or SNF result in a lower likelihood of oncologic follow-up and administration of further cancer-directed therapy.
Further study of ICI use near the end of life and the role of palliative care involvement is warranted.
Details
- Title: Subtitle
- Immune Checkpoint Inhibitor Use and Hospitalizations Near the End of Life (FR221)
- Creators
- Justin Buzick - University of Iowa Hospitals & ClinicsHe Chang - University of Iowa Hospitals and ClinicsChad Glisch - Medical College of WisconsinLaura Shinkunas - University of IowaYuya Hagiwara - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Journal of pain and symptom management, Vol.63(5), pp.808-809
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpainsymman.2022.02.253
- ISSN
- 0885-3924
- eISSN
- 1873-6513
- Language
- English
- Date published
- 05/2022
- Academic Unit
- General Internal Medicine; Internal Medicine; Medical Ethics
- Record Identifier
- 9984362740902771
Metrics
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